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    Optimal low-density lipoprotein is 50 to 70 mg/dl
    billh99 posted:
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    billh99 responded:
    I had a hard time posting this. Kept getting different error messages and had to try 3 different browsers.

    Anyway this is from the same report.

    How low is too low?. Cholesterol is an essential component of the cell membrane and an obligate precursor for bile acid, steroid hormone, and vitamin D synthesis. Consequently, it is likely that a physiologically ideal range of blood cholesterol exists above and below which adverse health consequences might be expected. Although individuals with serious chronic illnesses, such as cancer, often develop depressed LDL levels as a result of malnutrition, epidemiologic studies show that people with naturally low LDL levels are associated with improved longevity (27) . The cumulative experience with statin therapy shows impressive cardiovascular benefits that are directly proportional to LDL lowering with no increase in adverse events such as malignancy or non-cardiovascular mortality (5—12,18—26) . The incidence of the two principal adverse effects commonly attributed to statins—liver and muscle toxicity—rise modestly as a function of dose of statin utilized but not in relationship to the on-treatment LDL level (5—12) .
    People with heterozygous hypobetalipoproteinemia have total cholesterol levels as low as 80 mg/dl and LDL cholesterol levels as low as 30 mg/dl (30) . This condition is associated with longevity (31) , presumably due to the absence of atherosclerosis, but the lack of other adverse effects that might have accompanied a low LDL level suggests that such low levels of LDL are safe.
    Unintended benefits of LDL lowering. Inflammation and endothelial dysfunction, both important markers of abnormal vascular biology, have been shown to be improved as LDL is lowered to <80 mg/dl (12,24) . Statin therapy has been associated with reductions in the incidence of symptomatic peripheral vascular disease (32) , stroke (33) , dementia (34) , macular degeneration (35) , aortic stenosis (36) , and osteoporosis-related hip and vertebral fractures (37) . Although the mechanisms responsible for these benefits are not known, it is possible that an elevated LDL cholesterol level may be a common denominator predisposing to a wide variety of chronic degenerative diseases seen in modern civilization. If our genetically determined ideal LDL is indeed 50 to 70 mg/dl, perhaps lowering the currently average but elevated levels closer to the physiologically normal range may improve not just CHD but also many other diseases commonly attributed to the aging process. For all of these reasons, and given the safety record of statins, some investigators have suggested that statins be considered for routine use in individuals over age 55 years (38) ."
    billh99 replied to billh99's response:
    Even the first part got dropped.

    Optimal low-density lipoprotein is 50 to 70 mg/dl Lower is better and physiologically normal "" Evidence from hunter-gatherer populations while they were still following their indigenous lifestyles showed no evidence for atherosclerosis, even in individuals living into the seventh and eighth decades of life (15,16) . These populations had total cholesterol levels of 100 to 150 mg/dl with estimated LDL cholesterol levels of about 50 to 75 mg/dl. The LDL levels of healthy neonates are even today in the 30 to 70 mg/dl range. Healthy, wild, adult primates show LDL levels of approximately 40 to 80 mg/dl (17) . In fact, modern humans are the only adult mammals, excluding some domesticated animals, with a mean LDL level over 80 mg/dl and a total cholesterol over 160 mg/dl (15,16) (Fig. 1 ). Thus, although an LDL level of 50 to 70 mg/dl seems excessively low by modern American standards, it is precisely the normal range for individuals living the lifestyle and eating the diet for which we are genetically adapted."
    bobby75703 replied to billh99's response:
    Thank you Bill for posting that.

    I was especially intrigued by the first paragraph about the wild animals having low cholesterol levels.

    Low lipid levels is a symptom of what? The answer is an efficient metabolism. The cardiovascular benefit for these creatures, I believe, is coming from their efficient metabolism.

    Now I am not a wild monkey, although my friends may disagree. I personally would not want my LDL as low as 50. I've been there, and unfortunately thats when everything fell apart... For me at least.
    toneman84084 replied to billh99's response:
    I remember this article when the NCEP started an inquiry into lowering the recommended levels for TC and LDL. It was an interesting read then is still is today.

    What is important to take away from this is the levels of LDL corresponding to risk stratification. The number is a moving target based on each individual. I have kept my levels between 58 as a low and 77 currently and have felt no adverse symptoms. So for me with a relatively low risk stratification level, 58 may be fine. Perhaps for another 58 is too low based on their individual risk factors and overall conditioning.

    Thanks for the post!

    billh99 replied to toneman84084's response:
    For the last 2 years my levels have been between 55 and 74 on 40 mg Zocor.

    And I just got back from 19 mile bike ride, training for 65 mile ride in 4 weeks.
    toneman84084 replied to billh99's response:
    And I just got back from 19 mile bike ride, training for 65 mile ride in 4 weeks.

    We're into the same thing, I train approx 15 - 20 miles per day and try to maintain a max heart rate of about 85% - 90% of my max. I don't know about you, but since I stepped up to this level in January, I have seen my resting heart rate drop from the low 70's to an average of 60 in the past 30 days and my recovery heart rate increase to 35 - 40 BPM in the first minute from peak. I do enjoy riding the bike!
    Haylen_WebMD_Staff replied to toneman84084's response:
    OT - What brand of bikes do you ride for that type of distance? I'm guessing my 6 year olds Hello Kitty bike in my garage (complete with basket and bell) would not do the trick...

    toneman84084 replied to Haylen_WebMD_Staff's response:
    I ride a Giant Sedona, it's a "Urban Mountain Bike". It runs 21 gears and has the wider 1.95" tires as I spent a lot of time riding on dirt and over curbs and such. I like to ride between 15 - 20 miles a day depending on the winds. I have three routes mapped out and measured and I select which one I'll ride based on which direction wind is coming from and how my old knees are feeling at the time.

    It usually takes me 45 mins to ride 12 miles and in a little over an hour I can do 18 - 20 based on winds (can you tell, I hate riding into a wind). I keep my pace at the necessary level to keep my heart rate at 85% of my max target which means at peak I'll be doing about 150 - 155 BPM which translates to about 11 - 12 mets for me.

    Much fun!!
    billh99 replied to Haylen_WebMD_Staff's response:
    I have a 10 YO Diamondback Parkway. It is a Hybrid style. Much like Tony's, but looking at his spec's probably aim a bit more toward road and than mountain biking.

    Your basic bikes are road and mountain bikes.

    The road bikes have skinny tires, 1/2 - 3/4" wide for low rolling resistance on smooth road. Hard seats and low handlebars so that the rider stays low and has less wind resistance. And high gearing for speed.

    A mountain bike is made stronger (and heavier) to withstand rough terrain, including jumps, going over logs, etc. Wide knobby tires to grip in dirt and mud. Low gearing for hills. Handle bars shaped for upright riding. And suspensions (shock absorbers).

    My hybrid has medium wide tires, but with the center higher and smooth so that it has lower rolling resistance on roads, but the wider park with grip on soft surfaces. Low gearing - we have lots of hills. And a softer seat than a road bike, but no suspension, other than some springs on the seat.

    I mostly ride on the roads, but there are lots of places with patches and bumps and some loose gravel. And I ride a couple of bike paths with packed chat.

    So I like the hybrid. As in geezerhood bending over for a road bike is not easy.
    bobby75703 replied to Haylen_WebMD_Staff's response:

    I ride a 2006 Specialized Sirrus. Its an entry level road bike.

    If I were a cardiologist, I would whip out my prescription pad and prescribe a bicycle. I would also prescribe a good pair of running shoes.
    bobby75703 replied to Haylen_WebMD_Staff's response:
    Here ya go Haylen, This is a photo of my bike. An entry level road bike. Perfect for 15 to 20 mile rides. 24 lbs. Its a 2006 Specialized Sirrus Sport. It listed for $660 back in 2006.

    Its the best thing I have ever done for my cardiovascular health.
    toneman84084 replied to bobby75703's response:
    That's a nice bike, I ride with a friend with one of these, nothing entry level about it. My wife rides a Specialized as well, nice bikes.

    I agree, bike riding has done wonders for me. One of the real benefits for me is resting heart rate. Other work outs a great, but when bike season is here and I'm riding every day, my resting heart rate drops from the mid to upper 60's to the mid to upper 50's, that's huge. I don't get the same results riding indoors on a recumbent bike, just can't get the mets out if it.

    My Sedona, more of a tank as far as bikes go but I tend to be on unpaved trails and jumping curbs. New ones go for about the same price as yours;
    bobby75703 replied to toneman84084's response:
    Looks really good Tony! You can cover terrain with your bike that would bend my wheels.

    Ya know, if I was a cardiologist I think I would do something radical. I would park a bike in the waiting room with a note that says "Think about it"

    The walls of my waiting area would be covered with posters of people engaging in physically active sports. It would be like no other medical office in the world.
    Haylen_WebMD_Staff replied to bobby75703's response:
    NICE GUYS! I can't wait till my kids are old enough to ride - we live right by a bike path that they built a few years ago. And I'd love to take bikes to the beach. I don't think I have the time or stamina for the type of rides you guys are on! (I"m a walker/yoga person)

    Bobby - Dr. Beckerman is the kind of heart doctor your would appreciate! Ck out his post titled 'GET UP " All of his posts are great, IMO.


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